Form ID

Publication date

Location of premises

Certificate

Sewer, Water and Road Improvements

Date substantially performed:
Date certificate signed:

Participants

Name of Owner
Municipality of Chatham-Kent
Address of Owner
315 King Street West, PO Box 640, Chatham, ON N7M 5K8
Name of Contractor
M.R.
Name of Certifier
Earth Tech Canada Inc.
Address of Certifier
4510 Rhodes Drive, Suite 520, Windsor, ON N8W 5K5

Office to which claim for lien must be given to preserve lien

315 King Street West, PO Box 640, Chatham, ON N7M 5K8